As a multimedia visual artist in Vancouver and New York City, where she lived from 1994 to 1999, she explored in her paintings, photographs and videos themes of gender, sexuality, and race.

On the topic of her visual work, she has said that as a victim of child abuse she found it safer to use pictures rather than words.

[3] Set on a tropical island, the novel is narrated by a male nurse and caretaker, and explores trauma, madness and redemption, the legacies of sexual abuse, and the boundaries between heterosexual and homosexual desire.

[9] Viveka and her father's lives are each underpinned by the constraints of class and race, and most importantly by the sexual conventions of their society.

Set against its strongly evoked backdrop of place, the novel charts Viveka's coming to terms with the hard understanding that love faces society's obstacles, and her knowledge of her certain survival.

[9] Mootoo's two most recent novels, Moving Forward Sideways like a Crab (2014) and Polar Vortex (2020), were also shortlisted for the Giller Prize.

Mootoo's literary papers are held at Simon Fraser University Special Collections and Rare Books.

In 2008, the University of the West Indies, Cave Hill, Barbados, hosted a Symposium on the Fictions of Shani Mootoo in the Context of Caribbean Women's Writings.

In 1989 she addressed Sex Offenders at Stave Lake Correctional Centre about being a survivor of child abuse and suffering.